Many infants, especially premature infants, require hospitalization in an intensive care unit for medical conditions surrounding their birth. Examples of disease conditions requiring such ICU care are sepsis, respiratory distress, low blood sugar, and those requiring surgical intervention, to name just a few. Premature infants are more likely to require intensive care hospitalization than their term counterparts.
Infants hospitalized in the intensive care setting are monitored closely for heart rate, respiratory rate, pulse oximetry, and other vital signs. Of these, heart rate and respiratory rate are most often monitored using an EKG monitor. An EKG monitor displays heart rate and rhythm by detecting electrical signals coming from an infant's heart. Respiratory rate is displayed, as well, by detecting electrical impedance changes in the infant's chest wall. These electrical signals are picked up by electrodes affixed to the chest wall of the infant.
Typically, three electrodes are used for routine monitoring purposes. By convention, one electrode is placed over the upper right chest wall, another over the upper left chest wall, and one over the lower left chest wall. However, different electrode placement patterns can provide adequate EKG and respiratory rate detection for monitoring purposes, as long as the current path is sufficiently long to provide sufficient signal amplitude, and as long as convention is followed to produce wave-forms of the correct shape and vector.
The most critical factors in obtaining a satisfactory EKG tracing are skin resistance and electrode/skin contact. Current EKG electrodes use ionic, conductive materials designed to minimize skin impedance in order to acquire an adequate signal. State of the art electrodes have a highly conductive hydrogel or paste to maximize signal detection. Conductive hydrogels are also adhesive in nature. The hydrogel composition can be manipulated to enhance its adhesive properties to produce a sticky electrode that maintains tight fixation to the patient's chest to minimize noise from chest wall and electrode movement, and to prevent the electrode from detaching and interrupting the signal.
Other electrodes utilize a non-adhesive conductive paste to reduce skin resistance and detect the EKG signal; most often these electrodes are constructed with the conductive paste portion centered in an adhesive pad that provides for tight adherence to the patient's skin. All-metal EKG electrodes exhibit good conductivity, but must be securely attached to the skin to ensure good signal pickup and minimize motion artifact and detachment. Metal electrodes are usually simply taped to the skin to provide good electrode/skin contact.
A well recognized problem in the neonatal intensive care unit (NICU) is that often the adhesive nature of electrodes (either sticky hydrogel or adhesive backing) causes significant skin breakdown and injury. This problem is especially severe in the premature infant, whose thin skin is very fragile and subject to trauma. Also, chemical dermatitis caused by the skin adhesive can be unpredictable, leading to contact dermatitis and bullous skin lesions. Placement and removal of EKG electrode patches has been found to be a significant source of skin trauma in these patients; the skin tears and abrasions caused by electrode patch removal cause significant pain, and expose the baby to life threatening infections.
The current invention is designed to alleviate the problem of skin injury in newborn infants through a novel method of attaching EKG electrodes without the use of adhesive gels or materials.